1/28. Efficacy of spinal cord stimulation for neuropathic pain following idiopathic acute transverse myelitis: a case report.spinal cord stimulation (SCS) involves the electrical stimulation of dorsal structures within the spinal cord, and is the most widespread application of neurostimulation for the relief of chronic pain. Idiopathic acute transverse myelitis (IATM) is an acute monophasic lesion of the spinal cord that presents with symptoms associated with loss of cord function. The incidence of chronic pain secondary to this condition is unknown, but is considered rare. We report the efficacy of SCS for relief of severe neuropathic pain in both lower limbs secondary to IATM, which had failed to respond to conventional pain therapies.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
2/28. affect of deep brain stimulation on limb paresis after stroke.A deep brain stimulator was implanted in the periventricular grey matter of the third ventricle for pain after stroke in a man aged 48 years. As well as a beneficial analgesic effect, the patient reported improved function in the contralateral paretic arm, which was confirmed on formal testing.- - - - - - - - - - ranking = 4keywords = limb (Clic here for more details about this article) |
3/28. Tolosa Hunt syndrome--intractable pain treatment with acupuncture?PURPOSE: The Tolosa Hunt syndrome (THS) is a painful granular inflammation of the cerebral vessels followed by pain and disorders of the extrabulbar muscles. The therapy consists of corticosteroids and analgetics. There was a 70 year old woman who suffered from painful paresis of the abducent and oculomotor nerves following an infection with borrelia burgdorferi--but without ocular symptoms. The treatment with corticosteroids reduced the palsy but she complained of excessively painful attacks in the region of the first branch of the trigeminal nerve. Opiold analgetic therapy did not bring about any relief. acupuncture is an irritative method with a physical effect on the nervous system: its pain-reducing effect is caused by the activation of transmitters like endorphins in thalamus and brain stem. Knowing this effect, the THS patient, after informed consent, was treated with acupuncture. To measure the extent of pain, a visual analog scale (0: no pain - 10: maximum pain) was used. acupuncture was performed according to the empirical rules of the Traditional Chinese medicine (TCM), during a period of 10 weeks and 12 weeks. There was a significant pain relief after acupuncture from VAS 10 to VAS 5. The effect vanished during the next four months. After a second series of 12 sessions pain reduction was reported from VAS 10 to 4. One year after the last Tolosa Hunt syndrome - intractable pain pain strength ranged between VAS 4 - 6. Therefore acupuncture seems to be a good additional method for reduction of intractable pain.- - - - - - - - - - ranking = 0.17539329940414keywords = muscle (Clic here for more details about this article) |
4/28. Fulminant and relentless cutaneous necrosis with excruciating pain caused by calciphylaxis developing in a patient undergoing peritoneal dialysis.A 50-year-old Japanese female with chronic renal failure who had been on continuous ambulatory peritoneal dialysis developed fulminant systemic cutaneous necrosis that began as painful livedo reticularis-like skin lesions on her thighs. Because of disseminated vascular calcification within the muscular layer of her lower limbs, we eventually diagnosed her with calciphylaxis. The skin necrosis progressed rapidly, and she died of sepsis and pneumonia on the 53rd hospital day. In addition to her long-lasting severe hyperparathyroidism and extremely elevated serum phosphorus and calcium levels, mechanical, frictional stimulation inflicted on the local skin and administration of corticosteroids were suspected to have precipitated the calciphylaxis. Our lack of awareness of this disease in its early stages resulted in our missing the chance to do a parathyroidectomy that might have changed the course. It is important to know the clinical features of this rare disease in order to make a diagnosis as early as possible.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
5/28. midazolam for the treatment of phantom limb pain exacerbation: preliminary reports.Phantom pain is one of the most difficult intractable pains to manage. The pain may result from the imbalance of self-sustaining neural activity that exceeds the inhibitory control. The management of acute severe exacerbation of phantom pain is extremely difficult. midazolam acts by potentiation of gamma aminobutyric acid (GABA) and enhance the inhibitory action of glycine receptor at spinal neurons. We describe two preliminary reports of complete pain relief of severe phantom pain exacerbation by intravenous midazolam 3-5 mg.- - - - - - - - - - ranking = 4keywords = limb (Clic here for more details about this article) |
6/28. Complex regional pain syndrome post mastectomy.Complex regional pain syndrome includes the previously termed condition reflex sympathetic dystrophy. It is a chronic pain disorder diagnosed on the basis of symptoms and skin changes and is known to have a psychological element. It is a rare complication after surgery, especially mastectomy. We present two females who developed this syndrome after undergoing mastectomy for chronic mastalgia. These cases demonstrate that amputation of an organ for chronic pain can result in reflex sympathetic dystrophy developing in a nearby limb.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
7/28. Peripheral nerve division for relentless ischemic foot pain.During a three-year interval, 12 multisensory peripheral nerve divisions in ten patients were performed for intractable ischemic foot pain. The two major indications, after concluding that revascularization was impossible, were (1) the presence of localized, dry, and contained acral gangrene in patients who were not candidates for a lesser amputation and (2) patient or family refusal of a limb amputation.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
8/28. Restoration of hand function and so called "breathing arm" after intraspinal repair of C5-T1 brachial plexus avulsion injury. Case report.This 9-year-old boy sustained a complete right-sided C5-T1 brachial plexus avulsion injury in a motorcycle accident. He underwent surgery 4 weeks after the accident. The motor-related nerve roots in all parts of the avulsed brachial plexus were reconnected to the spinal cord by reimplantation of peripheral nerve grafts. Recovery in the proximal part of the arm started 8 to 10 months later. Motor function was restored throughout the arm and also in the intrinsic muscles of the hand by 2 years postoperatively. The initial severe excruciating pain, typical after nerve root avulsions, disappeared completely with motor recovery. The authors observed good recruitment of regenerated motor units in all parts of the arm, but there were cocontractions. transcranial magnetic stimulation produced response in all muscles, with prolonged latency and smaller amplitude compared with the intact side. There was inspiration-evoked muscle activity in proximal arm muscles--that is, the so-called "breathing arm" phenomenon. The issues of nerve regeneration after intraspinal reimplantation in a young individual, as well as plasticity and associated pain, are discussed. To the best of the authors' knowledge, the present case demonstrates, for the first time, that spinal cord surgery can restore hand function after a complete brachial plexus avulsion injury.- - - - - - - - - - ranking = 0.70157319761656keywords = muscle (Clic here for more details about this article) |
9/28. Special sunrise & sunset solar energy stored papers and their clinical applications for intractable pain, circulatory disturbances & cancer: comparison of beneficial effects between Special solar energy Stored paper and qigong Energy Stored paper.Various phases of solar energy were evaluated for possible medical application, using the Bi-Digital O-Ring Test. A 2-4 minute interval of highly beneficial phase during sunrise and sunset which is comparable or is stronger than ( ) qigong Energy was detected. This energy was stored on 3 x 5 inch index cards. The sun energy stored on the exposed surface had a Bi-Digital O-Ring Test extremely strong positive ( ) response, and the opposite side of the index card which was not exposed to the sun showed an equally strong negative (-) response. When the Bi-Digital O-Ring Test strong positive side ( ) was applied to the patient's skin above various intractable painful areas with circulatory disturbances, including gangrenous pain, muscle pain, joint pain, & migraine headache, most of the pain disappeared or was significantly reduced within between 10 seconds and 5 minutes, with accelerated wound healing compared with qigong energy stored paper of the same exposure, which caused pain to disappear within between 1.5 minutes and 15 minutes. When this Special solar energy Stored paper was applied either directly to the skin above cancer positive areas or the midline of the upper chest above the thymus gland representation area, or the occipital area above the medulla oblongata, various cancer related parameters returned to close to normal values, with immediate clinical improvement. The beneficial effects of 10-60 seconds of application of the Special solar energy Stored paper lasted for between 7 and 40 days, depending on the individual and their environmental electromagnetic field, how the special solar energy was stored, and how it was applied to the patient.- - - - - - - - - - ranking = 0.17539329940414keywords = muscle (Clic here for more details about this article) |
10/28. Late bacterial granuloma at an intrathecal drug delivery catheter.In the case reported, neurological complaints were pain and dysaesthesiae in the lower back and thigh, as well as paresis of the ileopsoas muscle. MRI of the lumbar spine showed an intradural-extramedullary mass at the level of L1 homogeneously enhancing with gadolinium. This mass was situated at the tip of an intrathecal catheter implanted 11 years before for a morphine trial infusion as therapy for phantom pain after amputation of the right arm. Now, removal of the catheter was performed. Cultures of lumbar CSF and the catheter tip demonstrated coagulase negative staphylococcus. Antibiotic medication with cephalosporines was given for 6 weeks. After removal of the catheter, the patient was free of pain and he progressively regained full neurological function. Although most catheter-associated granulomas reported so far were sterile in nature, bacterial infection should still be considered even years after catheter placement.- - - - - - - - - - ranking = 0.17539329940414keywords = muscle (Clic here for more details about this article) |
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